| History of Fractional CO2 Laser Technology |
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Below are a couple of excerpts from the article: "In the1990s, two new CO2 systems were developed to shorten the exposure time of the skin to this infrared light (the pulsed CO2 and the scanning spot CW CO2). Thegoal with any laser system is to avoid collateral damage when treatingthe target. This is done by keeping the exposure time to less than thethermal relaxation time of the target, preventing excessive spread ofheat to surrounding tissues. Exposure times less than or equal to onemillisecond have proven to be much safer with the CO2. The pulsed CO2 laser does just that. It delivers pulses of light of duration less than one millisecond. The high-energy short-pulsed systemuses a flash of energy that is short enough in duration to prevent heat from dissipating into surrounding tissue. The scannedcarbon dioxide laser system uses a computer-controlled mirror to rapidly scan an area in less time than is needed to expelheat into the bordering tissue. The scanning CO2 laser uses the continuous wave laser, but delivers spots with each exposure time less than one millisecond. Depth of tissueinjury is more controlled between 20 and 120 microns per pass. This reduces the potential for scarring. "Still, even with the pulsed and scanning spot deliveries, CO2 lasers do have their downside. Each physician using this laser must be well-trained in its capabilities and nuances. Eventhe pulsed and scanning CO2 lasers are extremely operator-dependent. The procedure is painful and requires some form of anesthesia. Patient selectionis an important part of success with CO2 resurfacing. In addition to selection for skin type, patients need to be properly counseled on the procedure and recovery.Healing after CO2 cantake two weeks or more, with some patients developing residual erythemafor months. Proper woundcare during the recovery phase is essential.Despite these precautions, some ideal patients treated at idealsettings still end up with complications including hypertrophicscarring, depigmentation, hyperpigmentation, or shiny,unnatural-appearing skin. Because of their flexibility and lowerside-effect profile, the high energy, pulsed and scanned CO2 lasers are now the models used for facial photorejuvenation. "For years researchers have been looking for laser treatments for photoaging that could compete with those of the CO2 lasers, but with a better safety profile. Safety became the focus of many lasers after the complications with the CW CO2 laser,and led to the introduction of the non-ablative laser systems. Focusnow has been on the fractional systems for photorejuvenation. Theoriginal fractional devices are within the non-ablative wavelengthranges with excellent clinical results and a superior safety profile.Still, the tissue contraction seen with the CO2 is difficult to duplicate, and hence the recent drive to re-invent the CO2. "Carbon dioxide laser resurfacing will continue to be one of many tools in the aesthetic market. Though the ideal settings,spot size, number of passes and number of treatments is still to be debated, restructuring the CO2 laser to improve its safety profile and patient tolerability, while preserving its efficacy, will surely be well-received.We can expect a huge comeback in carbon" dioxide resurfacing in the near future." 
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An interesting article appearing in the June 2007 issue of Dematology Times covered, in detail, the history of the CO2 laser technology. At Cresent Laser, we believe that Fractional CO2 lasers represent the most promissing new technology for aesthetic practitioners.